Development of standardized therapeutic model in Korean type 2 diabetic patients.
- Author:
Hae Won CHUNG
1
;
Yoo Mee KIM
;
Dae Jung KIM
;
Jae Hyun NAM
;
Chul Woo AHN
;
Bong Soo CHA
;
Young Duk SONG
;
Sung Kil LIM
;
Kyung Rae KIM
;
Hyun Chul LEE
;
Kap Bum HUH
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ylchodr@hotmail.com
- Publication Type:Original Article
- Keywords:
Diabetes Mellitus;
Staged Diabetes Management;
Insulin resistance;
Insulin secretion
- MeSH:
Anthropometry;
C-Peptide;
Diabetes Mellitus;
Fasting;
Glucose;
Humans;
Insulin;
Insulin Resistance
- From:Korean Journal of Medicine
2003;64(6):655-663
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: There are a few limitations in application of staged diabetes management (SDM) program to Korean type 2 diabetic patients because of their unique characteristics, such as non-obese but centrally obese anthropometry and variable relationships between insulin secretion and insulin resistance compared to western diabetic patients. Therefore, we proposed new therapeutic model which considers ethnic characteristics and assesses patient by insulin secretion and insulin resistance. METHODS: We have previously assessed patient's insulin secretion by serum fasting C-peptide level and insulin resistance by insulin tolerance test (ITT) and proposed new therapeutic model: by cut-off value of 2.5%/min in insulin resistance and 1.1 ng/dL, 1.7 ng/dL in insulin secretion. RESULTS: Total 183 patients were enrolled in this program and 59% of total subjects had to change the treatment modality according to this new therapeutic model. Mean fasting glucose level dropped from 177.0+/-38.6 mg/dL (9.83+/-2.14 mmol/L) to 148.2+/-31.2 mg/dL (8.23+/-1.73 mmol/L) (p<0.001), mean postprandial 2 hour glucose level dropped from 255.6+/-60.1 mg/dL (14.19+/-3.34 mmol/L) to 221.1+/-58.4 mg/dL (12.27+/-3.24 mmol/L) (p<0.001), mean HbA1c level dropped from 8.37+/-1.42% to 7.72+/-1.39% (p<0.001) even though baseline group already received conventional treatment. 51.4% of the post-treatment group achieved a HbA1c valued of less than 7.5% compared to 28.4% of the pre-treatment group. CONCLUSION: The new standardized therapeutic model strongly suggests its valuable clinical application in Korean type 2 diabetic patients.
